OCD chronic exhaustion ?

[UKmum68]

Hi folks, new here…

My daughter who is 20yrs has OCD (harm/pure) she started CBT/ERP/EMDR a few weeks back, I’m hopeful she’s in the right place. The thing I am desperately worried about and can’t seem to find any expert knowledge is that her exhaustion is chronic and I’m worried she might develop ME / chronic fatigue or something. She starts the day on a 1/10 energy levels and her brain is frazzled and can’t think, she says she feels very ill. She’s been practising not going into compulsions for a few months and is slowly making progress but the past month this acute exhaustion is extremely worrying. I’m wondering if it’s her nervous system/adrenals responding to being in fight / flight all the time. I don’t know how to help her. She often is shivering all day and can’t get warm. She now doesn’t have the energy to cope with the OCD. I wonder if you have any information on this? Many thanks 🙏🏼

[Bella1583]

Good morning, has your doctor checked her levels on vitamin deficiency and her thyroid? The first thing would be to check all of those because a deficiency can cause people to be tired. If that all came back fine then I think I would try to help make her a schedule to help her have some goals for the day. Things to get her up and moving. Like 3 small chores a day, 30 minutes outside, practicing mindfulness 2 times a day, ect. OCD and anxiety are EXHAUSTING, but getting them up and moving is the best thing you can do. Sending her and you lots of love this journey is a hard one.❤️

[UKmum68 in reply to Bella1583]

Bless you and thank you for replying. We’ve got a doctors appointment tmrw. And yep we get out most mornings for a walk. I need to try and get mindfulness practices back in. She found it difficult as the OCD would just take over but will try again. Thank you 🙏🏼

[Sallyskins]

I have often wondered if I have ME because I often feel tired, but having OCD is exhausting in itself, and I'm pretty sure that is the cause.

It could well be your daughter's adrenal glands going into overdrive - chronic stress can be tiring. And there is the emotional tiredness too - constantly fighting the OCD takes its toll on your brain.

It might be good for her to have a thorough check up with the doctor to make sure that there's no organic basis to her fatigue, if she is amenable.

Try to make sure she eats properly - don't nag her, of course, but do what you can - as low body weight can cause shivering and feeling cold. On the whole supplements are unnecessary if you're eating properly, but a daily dose of Vitamin D3 is good, along perhaps with a Vitamin B complex which is good for the brain and nerves.

Keeping a balance of activity and rest is important. Too much activity and you feel exhausted. Too much rest and you lose your get-up-and-go.

As for coping with OCD, it is a struggle and can leave one feeling as though one's batteries are low. If she can make room for some interests - reading, crafting, writing, music or anything else that takes her fancy - that could help her regain her energy. The occasional walk in the fresh air can also help.

My sympathies go out to your daughter and you - my own OCD first really hit me at around the age she is now. Make sure she knows that it's a manageable condition and needn't stop her from doing things she'd like to do.

[UKmum68 in reply to Sallyskins]

Thanks for responding 🙏🏼 I’m pleased I think we’re doing all the right things. Good nutrition, daily walks, and she’s an illustrator so her creativity is something she can still do and keeps her learning. She is unable to go anywhere on her own and so is trapped in the house so to speak for the past year. I’m optimistic she will get to a better place, it’s just how long that will be. She feels life is passing her by with friends gone to Uni and no social life etc. thank you for your encouragement. I feel she would benefit from perhaps joining a group of young adults with ocd for some connection and understanding so am going to research. Do you mind me asking how long it took for you to be able to live life again from when it hit you? Thank you.

[Sallyskins in reply to UKmum68]

It sounds as though she and you really are doing the right things! And that she's getting appropriate help is essential. CBT really does make a difference.

It took me much longer, simply because I didn't get the right treatment. So little was known or understood about OCD then - I didn't know I had it. My doctor prescribed antidepressants and I was all right in about six months, but then it hit me again a few years later - partly the stress of a boring, repetitive job where I couldn't use my abilities and was in constant with difficult bosses. I had to leave my job and go on benefits - fortunately there was the option of redundancy. I could barely do anything, let alone my job - and the stress of just getting to work - a two hour journey there and another two hours to get back - left me exhausted.

My mother bought me a book called Living with Fear by Dr Isaac Marks, which really made a difference. For a start, it described OCD and CBT. I had previously thought I was uniquely weird - now I knew my condition had a name and a treatment!

There have been ups and downs since, but I have been able to do things again. And now that your daughter is getting proper help, her recovery should be much more rapid.

I note that your daughter is having trouble getting out of the house. I did, too, and my first self-diagnosis was agoraphobia. I too found myself housebound, but I started going on little trips out to the shops and got more used to going out. I managed to have a pretty good social life in my twenties on the whole.

To have OCD often means to be isolated. A group of young OCD sufferers might be just the thing for your daughter.

As for education - she can do that when she's ready. I dropped out of university at 19 - apart from anything else, I was on the wrong course (Architecture) - but started back at university at 25 on a different course (English) much more suited to my abilities. More colleges and universities are doing part time courses now, and this might suit her better and give her a chance to rest. Also, part time courses are often aimed at mature students, and this could help. She might feel a bit out of things if she is on a course with a lot of school leavers younger than she is.

Illustrating is a wonderful career, and one that can offer flexible hours! And creativity is a marvellous therapy. And it really sounds as though she has a supportive family - that makes all the difference. She needn't miss out.

[Natureloverpeace]

It might help to have her family doctor or general practitioner see if there is something going on in addition to her OCD. Also, EMDR and talk therapy have been shown to be ineffective treatments for OCD.

[UKmum68 in reply to Natureloverpeace]

Thanks for responding. She’s got a new therapist who does CBT/ERP and EMDR which they are just about to get started with so hopeful that will help over time.

[Natureloverpeace in reply to UKmum68]

I see this as a red flag because licensed mental health therapists who specialize in OCD with specific training to treat OCD know not to use EMDR because it’s been proven to not treat OCD effectively. Talk therapy can make OCD worse because often the therapist offers reassurance which reinforces the OCD. ERP is the gold standard treatment for ERP because it has the most evidence to back up its effectiveness but that’s when it’s being done by a therapist who has been appropriately trained in it. It isn’t something that is taught in graduate school. It takes specific training and continuing education in that training to provide the expert care for effective, long-term recovery. ERP has evolved and isn’t just habituation anymore. It may also be enhanced with ACT and DBT. It also includes addressing and dealing with the core fear(s) underlying the OCD.